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Könemann H, Frommeyer G, Eckardt L. [ESC guideline 2022: management of ventricular arrhythmias in clinical practice]. Dtsch Med Wochenschr 2023; 148:325-330. [PMID: 36878232 DOI: 10.1055/a-1932-6711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
The recently published guideline of the European Society of Cardiology for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death updates the guideline from 2015. Overall, the current guideline is characterised by a great practical relevance: Illustrative algorithms, e.g., for diagnostic evaluation, and tables make the guideline a user-friendly reference book. In the diagnostic evaluation and risk stratification of sudden cardiac death, cardiac magnetic resonance imaging and genetic testing are significantly upgraded. In long-term management, the optimal treatment of the underlying disease is essential, and recommendations for heart failure therapy are adapted to current international guidelines. Catheter ablation is upgraded especially for patients with ischaemic cardiomyopathy and recurrent ventricular tachycardia, as well as in the management of symptomatic idiopathic ventricular arrhythmias. Criteria for primary prophylactic defibrillator therapy remain controversial. In the context of dilated cardiomyopathy, imaging, genetic testing, and clinical factors are given special weight in addition to left ventricular function. Additionally, revised diagnostic criteria for a large number of primary electrical diseases are provided.
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Affiliation(s)
- Hilke Könemann
- Rhythmologie, Klinik für Kardiologie II, Universitätsklinikum Münster, Münster
| | - Gerrit Frommeyer
- Rhythmologie, Klinik für Kardiologie II, Universitätsklinikum Münster, Münster
| | - Lars Eckardt
- Rhythmologie, Klinik für Kardiologie II, Universitätsklinikum Münster, Münster
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Long QT Syndrome, a Diagnosis That Warrants Expert Opinion and Expert Centers. J Am Coll Cardiol 2023; 81:487-489. [PMID: 36725177 DOI: 10.1016/j.jacc.2022.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 02/01/2023]
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Piciacchia F, Auricchio A, Behr ER, Wilde AA, Conte G. Family History of Sudden Cardiac Death in the Young and Inherited Arrhythmia Syndromes: Awareness and Attitudes of General Practitioners and Private Practice Cardiologists. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2023; 16:e003913. [PMID: 36716170 PMCID: PMC9946158 DOI: 10.1161/circgen.122.003913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Flavia Piciacchia
- Division of Cardiology, Cardiocentro Ticino Institute, Lugano, Switzerland (F.P., A.A., G.C.)
| | - Angelo Auricchio
- Division of Cardiology, Cardiocentro Ticino Institute, Lugano, Switzerland (F.P., A.A., G.C.).,Faculty of Biomedical Sciences, USI, Lugano, Switzerland (A.A., G.C.)
| | - Elijah R. Behr
- ERN GUARDHEART (E.R.B., A.A.M.W.),Cardiology Clinical Academic Group (E.R.B.),St. George’s, University of London and St. George’s University Hospitals NHS Foundation Trust, London, UK (E.R.B.)
| | - Arthur A.M. Wilde
- ERN GUARDHEART (E.R.B., A.A.M.W.),Department of Cardiology, Amsterdam UMC, University of Amsterdam, Heart Center, The Netherlands (A.A.M.W.)
| | - Giulio Conte
- Division of Cardiology, Cardiocentro Ticino Institute, Lugano, Switzerland (F.P., A.A., G.C.).,Faculty of Biomedical Sciences, USI, Lugano, Switzerland (A.A., G.C.)
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Zeppenfeld K, Tfelt-Hansen J, de Riva M, Winkel BG, Behr ER, Blom NA, Charron P, Corrado D, Dagres N, de Chillou C, Eckardt L, Friede T, Haugaa KH, Hocini M, Lambiase PD, Marijon E, Merino JL, Peichl P, Priori SG, Reichlin T, Schulz-Menger J, Sticherling C, Tzeis S, Verstrael A, Volterrani M. 2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Eur Heart J 2022; 43:3997-4126. [PMID: 36017572 DOI: 10.1093/eurheartj/ehac262] [Citation(s) in RCA: 686] [Impact Index Per Article: 343.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Siskin M, Cerrone M, Shokr M, Aizer A, Barbhaiya C, Dai M, Bernstein S, Holmes D, Knotts R, Park DS, Spinelli M, Chinitz LA, Jankelson L. ICD shocks and complications in patients with inherited arrhythmia syndromes. IJC HEART & VASCULATURE 2021; 37:100908. [PMID: 34765721 PMCID: PMC8569698 DOI: 10.1016/j.ijcha.2021.100908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 11/26/2022]
Abstract
Background There is limited information on the long-term outcomes of ICDs in patients with inherited arrhythmia syndromes. Methods Prospective registry study of inherited arrhythmia patients with an ICD. Incidence of therapies and complications were measured as 5-year cumulative incidence proportions and analyzed with the Kaplan-Meier method. Incidence was compared by device indication, diagnosis type and device type. Cox-regression analysis was used to identify predictors of appropriate shock and device complication. Results 123 patients with a mean follow up of 6.4 ± 4.8 years were included. The incidence of first appropriate shock was 56.52% vs 24.44%, p < 0.05 for cardiomyopathy and channelopathy patients, despite similar ejection fraction (61% vs 60%, p = 0.6). The incidence of first inappropriate shock was 13.46% vs 56.25%, p < 0.01 for single vs. multi-lead devices. The incidence of first lead complication was higher for multi-lead vs. single lead devices, 43.75% vs. 17.31%, p = 0.04. Patients with an ICD for secondary prevention were more likely to receive an appropriate shock than those with primary prevention indication (HR 2.21, CI 1.07-4.56, p = 0.03). Multi-lead devices were associated with higher risk of inappropriate shock (HR 3.99, CI 1.27-12.52, p = 0.02), with similar appropriate shock risk compared to single lead devices. In 26.5% of patients with dual chamber devices, atrial sensing or pacing was not utilized. Conclusion The rate of appropriate therapies and ICD complications in patients with inherited arrhythmia is high, particularly in cardiomyopathies with multi-lead devices. Risk-benefit ratio should be carefully considered when assessing the indication and type of device in this population.
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Affiliation(s)
- Matthew Siskin
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Marina Cerrone
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Mohamed Shokr
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Anthony Aizer
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Chirag Barbhaiya
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Matthew Dai
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Scott Bernstein
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Douglas Holmes
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Robert Knotts
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - David S Park
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Michael Spinelli
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Larry A Chinitz
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
| | - Lior Jankelson
- Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA
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Remme CA, Leclercq C, Behr ER. The European Cardiac Arrhythmia Genetics (ECGen) Focus Group. Eur Heart J 2021; 43:1891-1894. [PMID: 34617990 DOI: 10.1093/eurheartj/ehab698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Affiliation(s)
- Carol Ann Remme
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC, location Academic Medical Center, Amsterdam, The Netherlands
| | - Christophe Leclercq
- Cardiologie, CHU Rennes, INSERM, LTSI-UMR 1099, University of Rennes, Rennes 35000, France
| | - Elijah R Behr
- Cardiology Research Centre and Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Institute, St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK.,St. George's University Hospitals NHS Foundation Trust, London, UK
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